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A novel CBT-based intervention, tailored for young people, was developed in response to concerns about traditional diagnostically based approaches. Psychology of Emotions workshops use a normative approach to emotional difficulty instead of a diagnostic framework.

Aims:

To evaluate the acceptability and efficacy of Psychology of Emotions workshops within an IAPT service for young people aged 16–25 years.

Method:

This was a mixed-methods study, evaluating routinely collected self-report measures of depression and anxiety, and qualitative feedback forms. The main outcomes were rates of attendance, change in symptom severity, and participant views of the intervention.

Results:

From January to September 2016, 595 young people were invited to attend the Psychology of Emotions workshops, of whom 350 (58.8%) attended at least one session. Young people who attended all six sessions (8.1%) experienced significant reductions in self-reported anxiety (d = .72) and depression (d = .58) and 35.5% were classified as recovered at completion. Those who attended at least two sessions (41.3%) reported smaller but significant improvements in anxiety (d = .42) and depression (d = .45); 22.0% were classified as recovered at the last session attended. Participants provided largely positive feedback about the intervention.

Conclusion:

Psychology of Emotions is a promising treatment option, delivered outside of a diagnostic framework, for young people with mild to moderate mental health difficulties seen within IAPT services. Better understanding reasons for non-attendance might enable the intervention to be made accessible to more young people.

n = 24 participants were randomized to intervention and usual care groups. Workshop attendance was good and high levels of treatment satisfaction were reported, although feasibility challenges emerged in recruitment and randomization. Trends were found towards potential improvements in anxiety and well-being for the intervention group, but the effect estimate for depression was imprecise; interpretability was also limited due to the small sample size.

Conclusions:

DISCOVER appears to be a feasible and acceptable intervention model for clinically referred 15- to 18-year-olds with emotional difficulties. A full-scale RCT is warranted to evaluate effectiveness; protocol modifications may be necessary to ensure feasible recruitment and randomization procedures.

To better understand the maintenance of chronic fatigue syndrome (CFS), a valid and reliable measure of cognitive and behavioural responses to symptoms is required. Such a measure could also assess beliefs and coping behaviours in the context of fatigue in other somatic conditions.

Aims:

We aimed to establish the psychometric properties of both the Cognitive and Behavioural Responses Questionnaire (CBRQ) and its shortened version (CBRQ-S) in adolescents with CFS.

Method:

The full questionnaire was completed by a clinical cohort of adolescents (n = 121) presenting to specialist CFS units in the UK.

Results:

Both the CBRQ and CBRQ-S had good internal consistency. The CBRQ scores were strongly associated with depression, anxiety, school and social functioning, but weakly associated with fatigue and physical functioning, providing evidence of validity.

Conclusion:

Both the 40-item and the 18-item versions of the CBRQ were found to be reliable and valid in adolescents with CFS. To minimize unnecessary burden, the 18-item version is favoured. Using this assessment tool in future studies, including intervention studies, may help to better target interventions during clinical practice and improve outcomes.

Previous studies have indicated that people with social anxiety disorder (SAD) often experience spontaneous, recurrent images (SRI). It was assumed that Koreans with interdependent self-views may contain more features related to social contexts in their self-images than those reported in Western cultures.

Aims:

In the present study, we aimed to explore the prevalence and content of SRIs in individuals with SAD in Korea. Furthermore, we investigated the relationship between features of SRIs and variables of SAD.

Method:

Sixty-four individuals with SAD (27.00 ± 7.42 years, 64.1% female), diagnosed with SAD, completed self-report questionnaires related to social anxiety. Afterwards, a semi-structured interview was used to assess features and content of the individuals’ SRI.

The results demonstrated differences in the prevalence and content of the SRIs between Western and non-Western cultures. Fewer individuals with SAD in Korea reported having SRIs, and the content of these SRIs involved people other than the self. Some features of SRIs were associated with variables of SAD.

Despite its established efficacy, access to internet-delivered CBT (iCBT) remains limited in a number of countries. Translating existing programs and using a minimally monitored model of delivery may facilitate its dissemination across countries.

Aims:

This randomized control trial aims to evaluate the efficacy of an iCBT transdiagnostic program translated from English to French and offered in Canada using a minimally monitored delivery model for the treatment of anxiety and depression.

Method:

Sixty-three French speakers recruited in Canada were randomized to iCBT or a waiting-list. A French translation of an established program, the Wellbeing Course, was offered over 8 weeks using a minimally monitored delivery model. Primary outcome measures were the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), which were obtained pre-treatment, post-treatment and at 3-month follow-up.

Results:

Mixed-effects models revealed that participants in the treatment group had significantly lower PHQ-9 and GAD-7 scores post-treatment than controls with small between-groups effect sizes (d = 0.34 and 0.37, respectively). Within-group effect sizes on primary outcome measures were larger in the treatment than control group. Clinical recovery rates on the PHQ-9 and GAD-7 were significantly higher among the treatment group (40 and 56%, respectively) than the controls (13 and 16%, respectively).

Conclusions:

The provision of a translated iCBT program using a minimally monitored delivery model may improve patients’ access to treatment of anxiety and depression across countries. This may be an optimal first step in improving access to iCBT before sufficient resources can be secured to implement a wider range of iCBT services.

Involuntary mental imagery is elevated among people with bipolar disorder, and has been shown to shape biases in interpretation of ambiguous information. However, it is not clear whether biases in interpretation of ambiguous scenarios can be observed in those at risk for bipolar disorder, or whether involuntary imagery is related to such a bias.

Aims:

In the present study, we extended a prominent model of bipolar cognition to an at-risk sample. We specifically tested whether positive interpretation bias and involuntary mental imagery are linked to a greater risk of bipolar disorder.

The number of people growing older with severe mental illness (SMI) is rising, reflecting societal trends towards an ageing population. Evidence suggests that older people are less likely to seek help, be referred for and receive psychological therapy compared with younger people, but past research has focused on those with mild to moderate mental health needs.

Aims:

This research aims to identify the specific barriers faced by older people with SMI.

Method:

We interviewed 53 participants (22 service users with SMI aged over 50 years, 11 carers of people with SMI, and 20 health care professionals) about their views and experiences of accessing therapy for SMI in later life.

Barriers faced by older people with SMI are not only age-related, but also reflect specific issues associated with having a SMI over many years. Improving awareness of the benefits of psychological therapies is important not only for older people with SMI themselves, but also for their carers and staff who work with them.

Imagery rescripting (IR) for early aversive memories in patients with social anxiety disorder (SAD) has shown promising results, but no study has investigated the reactions and perspectives of patients who received IR.

Aims:

This study aimed to gain understanding of patients’ experiences/perspectives on IR as an adjunct to cognitive behavioural therapy (CBT) for SAD.

Method:

Twenty-five individuals with SAD received one or two sessions of IR over 16 CBT sessions. Contents of recurrent images and linked memories were identified during IR. Outcome measures included social anxiety, image and memory distress and vividness, and encapsulated belief. Patients completed a questionnaire about their perspectives of IR after the session. Thematic analysis was used to analyse the qualitative data.

Results:

IR resulted in significant within-session improvement in most outcome measures. Linked memories to negative recurrent images in social situations were categorized into nine groups. Common memories were ‘Being criticized by others’, ‘Being made fun of’, ‘Failing or not doing something well’ and ‘Being left out in a group’. Most patients (82%) experienced IR as impressive, and more than half of patients (59%) found IR effective. Themes of reasons of impressiveness and effectiveness were categorized as ‘Results of IR session’ and ‘Processes of IR session’. The theme ‘Results of IR session’ included six subthemes, and the theme ‘Processes of the IR session’ included five subthemes.

Conclusions:

Regarding patients’ perspectives, although they may experience negative emotions in the process of an IR session, our results suggest that many patients with SAD found IR sessions effective.

Thirty-eight university students attended two sessions, 7 days apart from each other. After completing perfectionism scales at the first session, they were asked to complete homework tasks from a self-help wellbeing booklet and return the booklet at session 2.

Results:

Only maladaptive facets of perfectionism correlated with most of the behavioural measures of procrastination. Moreover, those high in maladaptive perfectionism set and completed fewer planned activities to improve their mood.

Conclusions:

These findings suggest that perfectionism may affect how clients set their homework, and perfectionism may interfere with the homework assignments of CBT.

Metacognition refers to the ability to evaluate and control our cognitive processes. While studies have investigated metacognition in schizophrenia and clinical high risk for psychosis (CHR), less is known about the potential mechanisms which result in metacognitive deficits.

Aims:

We aimed to investigate whether neurocognitive functions including attention, working memory, verbal learning and executive functions predicted the tendency to focus on one’s thoughts (cognitive self-consciousness) and beliefs in the efficacy of one’s cognitive skills (cognitive confidence).

Method:

Participants (130 CHR individuals) were recruited as part of the multi-site PREDICT study. They were assessed using the Metacognitions Questionnaire (MCQ) as well as measures of executive function (WCST), attention (N-Back), working memory (LNS) and verbal learning (AVLT).

Results:

Cognitive competence was negatively correlated with N-Back while cognitive self-consciousness was positively correlated with N-Back and LNS. Linear regression analysis with N-Back, AVLT, LNS and WCST as predictors showed that neurocognition significantly predicted cognitive self-consciousness, with N-Back, LNS and WCST as significant predictors. The model accounted for 14% of the variance in cognitive self-consciousness. However, neurocognition did not result in a significant predictive model of cognitive competence.

Conclusions:

Neurocognition was associated with an increased focus on one’s thoughts, but it was not associated with higher confidence in one’s cognitive skills. Neurocognition accounted for less than one-sixth of the variance in metacognition, suggesting that interventions that target neurocognition are unlikely to improve metacognitive abilities.